Pain Management San Francisco
What Sets Us Apart

Acute and Chronic Pain
In their San Francisco pain management practice, Doctors Irène and Robert Minkowsky diagnose and provide treatment for both acute and chronic pain and related medical conditions. An acute pain problem develops suddenly and may be disabling. An example would be a lumbar or cervical spinal disc injury with nerve irritation such as sciatica or severe arm pain. Chronic pain usually develops more slowly and is persistent. It may also begin with an acute injury that does not resolve and becomes progressively more widespread. Different regions of the body may become involved, often at a distance from the site of the initial complaint. The chronic pain signals keep firing in the nervous system. Similar to a forest fire, the spread of the pain becomes difficult to contain. Chronic pain is defined as pain that persists for longer than 3-6 months. According to the NIH, in a 2012 survey, 25.3 million adults (11.2%) had chronic pain every day for the previous 3 months.

Chronic pain is a systemic total body problem that over time spreads to the emotional health and perspective of the patient. Only a global approach stands any chance of success. In vogue today as part of the treatment of chronic pain are nerve blocks, radiofrequency ablation, and spinal cord stimulation. In our experience, these medical approaches are band-aids on a systemic problem and rarely lead to long term good care and resolution of symptoms.

Doctors Irène & Robert Minkowsky are SF based chronic pain doctors and are experts in diagnosing and treating complex medical issues that cause pain and result in loss of function. They specialize in pain management using nonsurgical means to treat musculoskeletal conditions, spine disorders and sports injuries.

The Role of Manipulation
The musculoskeletal system is very complex and includes joints, ligaments, muscles, tendons nerves and blood vessels, all surrounded by fascia. All elements must be addressed for the successful resolution of a problem. As San Francisco pain management specialists, the Minkowskys frequently use osteopathic approaches and manipulation to treat their patients. This includes visceral and craniosacral manipulation. Manipulation has been shown to have a direct effect on the nervous system (J Man Manip Ther. 2010 Dec; 18(4): 181–190). This approach has the benefit of trying to reset the source of deregulation in the patient with chronic pain – the nervous system. It is a fallacy to believe that local invasive interventions are the best way to achieve this.

How We Diagnose
Jean Pierre Barral, a French osteopathic specialist, developed a technique called listening. Whenever the body struggles with a problem of balance – imbalance, tensions are created. Through training, a pain management specialist trained in osteopathy is able to detect where these abnormal tensions lie in the body. These are the most critical areas that require treatment, as they are usually the source of a problem. The use of this technique is particularly helpful in longstanding problems of chronic pain in which multiple compensatory layers have been created and current symptoms are often far removed from the original source of a patient’s problem. As San Francisco chronic pain doctors and specialists, Drs. Irène and Robert Minkowsky use this technique in their patient evaluation, often helping them unravel difficult cases where a patient has been previously seen by multiple physicians without success.

In their pain management office, the Minkowskys emphasize a thorough comprehensive evaluation that precedes an individualized treatment program with an emphasis on restoration of musculoskeletal balance, control of pain (principally nonpharmacologic) and recovery of function. Their success stems from being eclectic, thorough and methodical in their approach.

Chronic Pain Conditions We Provide Treatment For

  • Back Pain
  • Neck Pain
  • Thoracic Pain
  • Rib Pain
  • Coccydynia
  • Disc Herniation
  • Sciatica
  • Piriformis Syndrome
  • Headache and Migraine
  • TMJ and Facial Pain
  • Neuralgia / Neuropathy
  • Peripheral Joints (shoulder, hip, knee, ankle)
  • Spinal Stenosis and Other Spine Medical Conditions
  • Facet Arthritis
  • Post-Surgical Pain
  • Repetitive Strain Injury
  • Scoliosis
  • Sports Injuries
  • Tendinitis
  • Functional Gastrointestinal and Genitourinary Disorders (heartburn, GE reflux, IBS, Pelvic Pain)eviews

Physicians' Back Institute SF

Schedule Your Consultation Today
(415) 776-4644

Don’t let chronic pain and musculoskeletal injuries affect your quality of life. Drs. Irène and Robert Minkowsky have helped thousands of patients. Let the doctors at the Physicians’ Back Institute treat you so you can enjoy an active lifestyle. They are proud to serve the San Francisco Bay Area.

We are located at
2000 Van Ness Ave, #305
San Francisco, CA 94109
(415) 776-4644
Call us for more information about how we can help you.

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